Tibay v. Court of Appeals
G. R. No. 119655, 24 May 1996
257 SCRA 126
Facts:
Fortune Life and General Insurance Co. issued a fire insurance policy in favour of Victoria
Tibay and/or Nicolas Roraldo on their 2-storey residential building at Makati City. With the
total premium of P2,983.50, Tibay only paid P600.00,thus leaving a considerable balance
unpaid. Later on, the insured building was completely destroyed by fire. Two days later, Tibay
paid the remaining balance of the premium, then later on, filed a claim with Fortune but it was
denied, thus, the filing of the case by Tibay in court after failure to settle it with the Insurance
Commission. The trial court ruled in favour of Tibay but was reversed by the Court of Appeals.
Issue:
Whether or not the fire insurance is valid upon mere partial payment of premium.
Held:
No.
Conformably with the aforesaid stipulations explicitly worded and taken in conjunction with
Sec. 77 of the Insurance Code the payment of partial premium by the assured in this
particular instance should not be considered the payment required by the law and the
stipulation of the parties. Rather, it must be taken in the concept of a deposit to be held in
trust by the insurer until such time that the full amount has been tendered and duly receipted
for. In other words, as expressly agreed upon in the contract, full payment must be made
before the risk occurs for the policy to be considered effective and in force.
Thus, no vinculum juris whereby the insurer bound itself to indemnify the assured according
to law ever resulted from the fractional payment of premium. The insurance contract itself
expressly provided that the policy would be effective only when the premium was paid in full.
It would have been altogether different were it not so stipulated. Ergo, petitioners had
absolute freedom of choice whether or not to be insured by FORTUNE under the terms of its
policy and they freely opted to adhere thereto.
Indeed, and far more importantly, the cardinal polestar in the construction of an insurance
contract is the intention of the parties as expressed in the policy. Courts have no other
function but to enforce the same. The rule that contracts of insurance will be construed in
favor of the insured and most strongly against the insurer should not be permitted to have the
effect of making a plain agreement ambiguous and then construe it in favor of the insured.
Verily, it is elemental law that the payment of premium is requisite to keep the policy of
insurance in force. If the premium is not paid in the manner prescribed in the policy as
intended by the parties the policy is ineffective. Partial payment even when accepted as a
partial payment will not keep the policy alive even for such fractional part of the year as the
part payment bears to the whole payment.
Philippine Phoenix Surety and Insurance, Inc. v. Woodworks, Inc.
G. R. No. L-22684, 31 August 1967
20 SCRA 1270
Facts:
Philippine Phoenix Surety and Insurance, Inc. issued a fire insurance policy to Woodworks,
Inc., in which the latter paid P3,000.00. Later on, Phoenix made several demands on
Woodworks to pay the amount of P3,522.09, thus, an action filed in court by Phoenix. The
municipal court ruled in favor of the latter which was sustained by the Court of First Instance.
Issue:
Whether or not the non-payment of premium will not cancel the policy.
Held:
Yes.
It is clear from the foregoing that on April 1, 1960 Fire Insurance Policy No. 9652 was issued
by appellee and delivered to appellant, and that on September 22 of the same year, the latter
paid to the former the sum of P3,000.00 on account of the total premium of P6,051.95 due
thereon. There is, consequently, no doubt at all that, as between the insurer and the insured,
there was not only a perfected contract of insurance but a partially performed one as far as
the payment of the agreed premium was concerned. Thereafter the obligation of the insurer
to pay the insured the amount for which the policy was issued in case the conditions therefor
had been complied with, arose and became binding upon it, while the obligation of the
insured to pay the remainder of the total amount of the premium due became demandable.
We can not agree with appellant’s theory that non-payment by it of the premium due,
produced the cancellation of the contract of insurance. Such theory would place exclusively in
the hands of one of the contracting parties the right to decide whether the contract should
stand or not. Rather the correct view would seem to be this: as the contract had become
perfected, the parties could demand from each other the performance of whatever obligations
they had assumed. In the case of the insurer, it is obvious that it had the right to demand from
the insured the completion of the payment of the premium due or sue for the rescission of the
contract. As it chose to demand specific performance of the insured’s obligation to pay the
balance of the premium, the latter’s duty to pay is indeed indubitable.
VII. Persons entitled to recover on the policy and conditions to recovery
Topic: Beneficiary
Bonifacio Bros., Inc. v. Mora
G. R. No. L-20853, 29 May 1967
20 SCRA 262
Facts:
Enrique Mora mortgaged his Oldsmobile Sedan model 1956 to H. S. Reyes, Inc. with the
condition that the former would insure the automobile with the latter as beneficiary, which was
later insured with the State Bonding and Insurance Co., Inc. Later on, the car met with an
accident. Mora, without the knowledge and consent of H. S. Reyes, authorized the Bonifacio
Bros., Inc. to furnish the labor and materials. Later on, the car was delivered to Mora without
the consent of H. S. Reyes, and without payment to Bonifacio Bros.
Bonifacio Bros., later on filed a case against Mora for their belief that the insurance proceeds
shall be paid directly to them. The municipal court ordered State Bonding to pay H. S. Reyes
the sum claimed, which was affirmed by the Court of First Instance.
Issue:
Whether or not H. S. Reyes asa the right to the insurance proceeds only if there was loss and
not where there is mere damage.
Held:
Yes.
Suffice it to say that any attempt to draw a distinction between "loss" and "damage" is
uncalled for, because the word "loss" in insurance law embraces injury or damage.
Loss in insurance, defined. — The injury or damage sustained by the insured in consequence
of the happening of one or more of the accidents or misfortune against which the insurer, in
consideration of the premium, has undertaken to indemnify the insured. (1 Bouv. Ins. No.
1215; Black's Law Dictionary; Cyclopedic Law Dictionary, cited in Martin's Phil. Commercial
Laws, Vol. 1, 1961 ed. p. 608).
Indeed, according to sec. 120 of the Insurance Act, a loss may be either total or partial.
Insular Life Assurance Company, Ltd. v. Ebrado
G. R. No. L-44059, 28 October 1977
80 SCRA 281
Facts:
Buenaventura Ebrado was issued a policy by Insular Life for accidental death in which he
designated his wife as his beneficiary. He died however when he was hit by a falling branch
of a tree. His wife Carponia filed a claim for the proceeds of the policy, although she admitted
that they lived together as husband and wife without the benefit of marriage. Pascualvda. De
Ebrado also filed her claim as the widow of the deceased , insisting her entitlement to the
proceeds, not the common-law wife. The trial court held that Carponia is disqualified from
becoming beneficiary of the deceased. She appealed her case to the CA, but the latter
certified it to the Supreme Court.
Issue:
Whether or not a common-law wife can be designated as beneficiary.
Held:
No.
In essence, a life insurance policy is no different from a civil donation insofar as the
beneficiary is concerned. Both are founded upon the same consideration: liberality. A
beneficiary is like a donee, because from the premiums of the policy which the insured pays
out of liberality, the beneficiary will receive the proceeds or profits of said insurance. As a
consequence, the proscription in Article 739 of the new Civil Code should equally operate in
life insurance contracts. The mandate of Article 2012 cannot be laid aside: any person who
cannot receive a donation cannot be named as beneficiary in the life insurance policy of the
person who cannot make the donation. Under American law, a policy of life insurance is
considered as a testament and in construing it, the courts will, so far as possible treat it as a
will and determine the effect of a clause designating the beneficiary by rules under which
wins are interpreted.
Vda.deConsuegra v. Government Service Insurance System
G. R. No. L-28093, 30 January 1971
37 SCRA 315
Facts:
The late Jose Consuegra during his lifetime had two marriages: the first which bore two
children, but both predeceased their father; and the second one which were solemnized in
good faith while the first was subsisting and bore 7 children. Being a member of GSIS when
he died, the proceeds were paid to the second wife BasiliaBerdinvda. deConsuegra. The first
wife filed a claim asking that the proceeds shall be paid to her as the only legal heir of the
decedent. Later on, Vda.deConsuegra filed a case in court against GSIS, praying that they
shall be declared as beneficiaries of the retirement insurance of the decedent, in which the
trial court ruled in their favor.
Issue:
Whether or not Vda. deConsuegra and her children are the legal heirs of the retirement
insurance of the deceased.
Held:
Yes.
In the case of the proceeds of a life insurance, the same are paid to whoever is named the
beneficiary in the life insurance policy. As in the case of a life insurance provided for in the
Insurance Act (Act 2427, as amended), the beneficiary in a life insurance under the GSIS
may not necessarily be a heir of the insured. The insured in a life insurance may designate
any person as beneficiary unless disqualified to be so under the provisions of the Civil Code.
And in the absence of any beneficiary named in the life insurance policy, the proceeds of the
insurance will go to the estate of the insured.
Retirement insurance is primarily intended for the benefit of the employee — to provide for
his old age, or incapacity, after rendering service in the government for a required number of
years. If the employee reaches the age of retirement, he gets the retirement benefits even to
the exclusion of the beneficiary or beneficiaries named in his application for retirement
insurance. The beneficiary of the retirement insurance can only claim the proceeds of the
retirement insurance if the employee dies before retirement. If the employee failed or
overlooked to state the beneficiary of his retirement insurance, the retirement benefits will
accrue to his estate and will be given to his legal heirs in accordance with law, as in the case
of a life insurance if no beneficiary is named in the insurance policy.
It is Our view, therefore, that the respondent GSIS had correctly acted when it ruled that the
proceeds of the retirement insurance of the late Jose Consuegra should be divided equally
between his first living wife Rosario Diaz, on the one hand, and his second wife BasiliaBerdin
and his children by her, on the other; and the lower court did not commit error when it
confirmed the action of the GSIS, it being accepted as a fact that the second marriage of
Jose Consuegra to BasiliaBerdin was contracted in good faith. The lower court has correctly
applied the ruling of this Court in the case of Lao, et al. vs. Dee Tim, et al., 45 Phil. 739 as
cited in the stipulation of facts and in the decision appealed from. In the recent case of
Gomez vs. Lipana, L-23214, June 30, 1970, this Court, in construing the rights of two women
who were married to the same man — a situation more or less similar to the case of appellant
BasiliaBerdin and appellee Rosario Diaz — held "that since the defendant's first marriage has
not been dissolved or declared void the conjugal partnership established by that marriage
has not ceased. Nor has the first wife lost or relinquished her status as putative heir of her
husband under the new Civil Code, entitled to share in his estate upon his death should she
survive him. Consequently, whether as conjugal partner in a still subsisting marriage or as
such putative heir she has an interest in the husband's share in the property here in
dispute.... " And with respect to the right of the second wife, this Court observed that although
the second marriage can be presumed to be void ab initio as it was celebrated while the first
marriage was still subsisting, still there is need for judicial declaration of such nullity. And
inasmuch as the conjugal partnership formed by the second marriage was dissolved before
judicial declaration of its nullity, "[t]he only lust and equitable solution in this case would be to
recognize the right of the second wife to her share of one-half in the property acquired by her
and her husband and consider the other half as pertaining to the conjugal partnership of the
first marriage."
Go v. Redfern
G. R. No. L-47705, 25 April 1941
72 Phil. 71
Facts:
Edward Redfern obtained an insurance policy against accidents from the International
Assurance Co., Ltd. Later, he died as a result of an accident. The mother of the deceased
filed a claim but it was refused by the insurance company because of the amended policy in
which Concordia Go was added as beneficiary.
Issue:
Whether or not the designation of Go as beneficiary is valid.
Held:
Yes.
In the case of Wallace v. Mutual Benefit Life Insurance Co. doctrine sat the following: Upon
the issuance of a policy, the beneficiary or the beneficiary of it acquires a right which can not
be deprived without their consent, unless it has reserved specifically the insured the right to
change the policy. Same doctrine enunciated by this Court in the cases of Gercio v
Assurance Sun Life Co. of Canada (48 Phil. Rep., 55) and Insular Life v Suva (34 Off. Gaz.
861)
We, therefore, that unless the insured has expressly reserved the right to change or modify
the policy in respect of the beneficiary of it, this policy is an acquired right of the beneficiary,
which can not be changed except with the consent. And such is the case before us. This
allowed the insured Edward K. Redfern is not expressly reserve the right to change or modify
the policy. The appellant maintains, however, that the addition of his name as one of the
beneficiaries of the policy is not change. Change involves the idea of alteration. And every
addition is alteration. Then have added the name of the appellant was altered, ie, the policy
was changed in form, inasmuch as, with the addition of the name of the appellant, that
already has two beneficiaries, instead of one as at its bottom, since the original beneficiary
did not receive the full amount of the policy. So the appellant's argument lacks merit.
Topic: Loss
Country Bankers Insurance Corporation v. Lianga Bay and Community Multi-Purpose
Cooperative, Inc.
G. R. No. 136914, 25 January 2002
374 SCRA 653
Facts:
Country Bankers issued a fire insurance policy to Lianga Bay, in which the building of the
latter were destroyed by fire, resulting in the loss of the insured stocks-in-trade, among
others. Lianga Bay filed a claim to Country Bankers but it was denied because the building
was burned by NPA rebels, which is an excepted risk under the fire insurance policy. Lianga
Bay filed a case against Country Bankers, in which the trial court ruled in favor of the former
and affirmed by the CA.
Issue:
Whether or not the loss incurred is covered by the policy.
Held:
Yes.
In the instant case, the petitioner does not dispute that the respondent’s stocks-in-trade were
insured against fire loss, damage or liability under Fire Insurance Policy No. F- 1397 and that
the respondent lost its stocks-in-trade in a fire that occurred on July 1, 1989, within the
duration of said fire insurance. The petitioner, however, posits the view that the cause of the
loss was an excepted risk under the terms of the fire insurance policy.
Where a risk is excepted by the terms of a policy which insures against other perils or
hazards, loss from such a risk constitutes a defense which the insurer may urge, since it has
not assumed that risk, and from this it follows that an insurer seeking to defeat a claim
because of an exception or limitation in the policy has the burden of proving that the loss
comes within the purview of the exception or limitation set up. If a proof is made of a loss
apparently within a contract of insurance, the burden is upon the insurer to prove that the loss
arose from a cause of loss which is excepted or for which it is not liable, or from a cause
which limits its liability. Stated else wise, since the petitioner in this case is defending on the
ground of non-coverage and relying upon an exemption or exception clause in the fire
insurance policy, it has the burden of proving the facts upon which such excepted risk is
based, by a preponderance of evidence. But petitioner failed to do so.
X. Marine Insurance
Topic: Risks or losses covered in marine insurance
Subtopic: Perils of the sea vs. Perils of the ship
Roque v. Intermediate Appellate Court
G. R. No. L-66935, 11 November 1985
139 SCRA 596
Facts:
The Manila Bay Lighterage Corporation entered into a contract with Isabela Roque Timber
Enterprises whereby the former would carry and load on board its barge from Malampaya
Sound, palawan to Manila North Harbor, in which the logs were insured with Pioneer
Insurance and Surety Corporation. The barge where the logs were loaded was allegedly not
seaworthy such that it developed a leak, which was also found that there was one hatch open
which caused the water to enter the barge Roque filed a claim with Pioneer but it was refused
on the ground that its hability depended upon the "total loss by total loss of vessel only," thus,
an action in court. The trial court ruled in favor of Roque, which was reversed by the CA with
modification.
Issue:
Whether or not the loss was occasioned by the perils of the sea.
Held:
Yes.
It is quite unmistakable that the loss of the cargo was due to the perils of the ship rather than
the perils of the sea. The facts clearly negate the petitioners' claim under the insurance
policy. In the case of Go Tiaoco y Hermanos v. Union Ins. Society of Canton, supra, we had
occasion to elaborate on the term "perils of the ship." We ruled:
It must be considered to be settled, furthermore, that a loss which, in the ordinary course of
events, results from the natural and inevitable action of the sea, from the ordinary wear and
tear of the ship, or from the negligent failure of the ship's owner to provide the vessel with
proper equipment to convey the cargo under ordinary conditions, is not a peril of the sea.
Such a loss is rather due to what has been aptly called the "peril of the ship." The insurer
undertakes to insure against perils of the sea and similar perils, not against perils of the ship.
As was well said by Lord Herschell in Wilson, Sons & Co. v. Owners of Cargo per the Xantho
([1887], 12 A. C., 503, 509), there must, in order to make the insurer liable, be some casualty,
something which could not be foreseen as one of the necessary incidents of the adventure.
The purpose of the policy is to secure an indemnity against accidents which may happen, not
against events which must happen.
In the present case the entrance of the sea water into the ship's hold through the defective
pipe already described was not due to any accident which happened during the voyage, but
to the failure of the ship's owner properly to repair a defect of the existence of which he was
apprised. The loss was therefore more analogous to that which directly results from simple
unseaworthiness than to that which result from the perils of the sea.
xxxxxxxxx
Suffice it to say that upon the authority of those cases there is no room to doubt the liability of
the shipowner for such a loss as occurred in this case. By parity of reasoning the insurer is
not liable; for generally speaking, the shipownerexcepts the perils of the sea from his
engagement under the bill of lading, while this is the very perils against which the insurer
intends to give protection. As applied to the present case it results that the owners of the
damaged rice must look to the shipowner for redress and not to the insurer.
Oriental Assurance Corporation v. Court of Appeals
G. R. No. 94052, 9 August 991
200 SCRA 459
Facts:
Panama Saw Mill Co., Inc. insured its apitong logs with Oriental Assurance Corporation,
which later hired Transpacific Towage, Inc. to transport them by sea to Manila through 2
barges. They were towed by one tug boat, but during the voyage, rough seas and strong
winds caused damage to one of the barges resulting in the loss of some of the logs loaded.
Panama demanded payment for the loss but Oriental refused on the ground that its
contracted liability was for "total loss only." Panama filed a case against Oriental in which the
trial court ruled in favor of the former. The CA affirmed the said decision.
Issue:
Whether or not the loss is a constructive total loss.
Held:
No.
More importantly, the insurer's liability was for "total loss only." A total loss may be either
actual or constructive (Sec. 129, Insurance Code). An actual total loss is caused by:
(a) A total destruction of the thing insured;
(b) The irretrievable loss of the thing by sinking, or by being broken up;
(c) Any damage to the thing which renders it valueless to the owner for the purpose for which
he held it; or
(d) Any other event which effectively deprives the owner of the possession, at the port of
destination, of the thing insured. (Section 130, Insurance Code).
A constructive total loss is one which gives to a person insured a right to abandon, under
Section 139 of the Insurance Code. This provision reads:
SECTION 139. A person insured by a contract of marine insurance may abandon the thing
insured, or any particular portion thereof separately valued by the policy, or otherwise
separately insured, and recover for a total loss thereof, when the cause of the loss is a peril
injured against,
(a) If more than three-fourths thereof in value is actually lost, or would have to be expended
to recover it from the peril;
(b) If it is injured to such an extent as to reduce its value more than three-fourths;
xxxxxxxxx
(Emphasis supplied)
Respondent Appellate Court treated the loss as a constructive total loss, and for the purpose
of computing the more than three-fourths value of the logs actually lost, considered the cargo
in one barge as separate from the logs in the other. Thus, it concluded that the loss of 497
pieces of logs from barge TPAC-1000, mathematically speaking, is more than three-fourths
(¾) of the 598 pieces of logs loaded in that barge and may, therefore, be considered as
constructive total loss.
The basis thus used is, in our opinion, reversible error. The requirements for the application of
Section 139 of the Insurance Code, quoted above, have not been met. The logs involved,
although placed in two barges, were not separately valued by the policy, nor separately
insured. Resultantly, the logs lost in barge TPAC-1000 in relation to the total number of logs
loaded on the same barge can not be made the basis for determining constructive total loss.
The logs having been insured as one inseparable unit, the correct basis for determining the
existence of constructive total loss is the totality of the shipment of logs. Of the entirety of
1,208, pieces of logs, only 497 pieces thereof were lost or 41.45% of the entire shipment.
Since the cost of those 497 pieces does not exceed 75% of the value of all 1,208 pieces of
logs, the shipment can not be said to have sustained a constructive total loss under Section
139(a) of the Insurance Code.
Sun Insurance Office. Ltd. v. Court of Appeals
G. R. No. 92383, 17 July 1992
211 SCRA 554
Facts:
Sun Insurance Office issued a personal accident policy to Felix Lim, Jr. Two months later,
while being in a happy mood on a party, he played with his handgun and accidentally shot
himself in the head. His widow Nerissa filed a case in court which ruled in her favor and
affirmed by the CA.
Issue:
Whether or not the death of Felix Lim, Jr. was an accident.
Held:
Yes.
The words "accident" and "accidental" have never acquired any technical signification in law,
and when used in an insurance contract are to be construed and considered according to the
ordinary understanding and common usage and speech of people generally. In-substance,
the courts are practically agreed that the words "accident" and "accidental" mean that which
happens by chance or fortuitously, without intention or design, and which is unexpected,
unusual, and unforeseen. The definition that has usually been adopted by the courts is that
an accident is an event that takes place without one's foresight or expectation — an event
that proceeds from an unknown cause, or is an unusual effect of a known case, and therefore
not expected.
An accident is an event which happens without any human agency or, if happening through
human agency, an event which, under the circumstances, is unusual to and not expected by
the person to whom it happens. It has also been defined as an injury which happens by
reason of some violence or casualty to the injured without his design, consent, or voluntary
co-operation.
In light of these definitions, the Court is convinced that the incident that resulted in Lim's
death was indeed an accident. The petitioner, invoking the case of De la Cruz v. Capital
Insurance, says that "there is no accident when a deliberate act is performed unless some
additional, unexpected, independent and unforeseen happening occurs which produces or
brings about their injury or death." There was such a happening. This was the firing of the
gun, which was the additional unexpected and independent and unforeseen occurrence that
led to the insured person's death.
Finman General Assurance Corporation v. Court of Appeals
G. R. No. 100970, 2 September 1992
213 SCRA 493
Facts:
Carlie Surposa was insured with Finman under its General Teachers Protection Plan Master
Policy with his parents and siblings as beneficiaries. While the policy is in effect, she died of a
stab wound inflicted by one of the three unidentified men while waiting for a ride on their way
home after attending the Maskara Festival. The beneficiaries filed their claim with Finman but
it was denied on the ground that murder and assault are not covered by the policy. They filed
a case with the Insurance Commission in which it ruled in their favor, which was affirmed by
the CA.
Issue:
Whether or not the murder of Carlie Surposa can be covered by the policy.
Held:
Yes.
The terms "accident" and "accidental" as used in insurance contracts have not acquired any
technical meaning, and are construed by the courts in their ordinary and common
acceptation. Thus, the terms have been taken to mean that which happen by chance or
fortuitously, without intention and design, and which is unexpected, unusual, and unforeseen.
An accident is an event that takes place without one's foresight or expectation — an event
that proceeds from an unknown cause, or is an unusual effect of a known cause and,
therefore, not expected.
. . . The generally accepted rule is that, death or injury does not result from accident or
accidental means within the terms of an accident-policy if it is the natural result of the
insured's voluntary act, unaccompanied by anything unforeseen except the death or injury.
There is no accident when a deliberate act is performed unless some additional, unexpected,
independent, and unforeseen happening occurs which produces or brings about the result of
injury or death. In other words, where the death or injury is not the natural or probable result
of the insured's voluntary act, or if something unforeseen occurs in the doing of the act which
produces the injury, the resulting death is within the protection of the policies insuring against
death or injury from accident.
As correctly pointed out by the respondent appellate court in its decision:

In the case at bar, it cannot be pretended that Carlie Surposa died in the course of an assault
or murder as a result of his voluntary act considering the very nature of these crimes. In the
first place, the insured and his companion were on their way home from attending a festival.
They were confronted by unidentified persons. The record is barren of any circumstance
showing how the stab wound was inflicted. Nor can it be pretended that the malefactor aimed
at the insured precisely because the killer wanted to take his life. In any event, while the act
may not exempt the unknown perpetrator from criminal liability, the fact remains that the
happening was a pure accident on the part of the victim. The insured died from an event that
took place without his foresight or expectation, an event that proceeded from an unusual
effect of a known cause and, therefore, not expected. Neither can it be said that where was a
capricious desire on the part of the accused to expose his life to danger considering that he
was just going home after attending a festival.
Furthermore, the personal accident insurance policy involved herein specifically enumerated
only ten (10) circumstances wherein no liability attaches to petitioner insurance company for
any injury, disability or loss suffered by the insured as a result of any of the stimulated
causes. The principle of " expresso uniusexclusioalterius" — the mention of one thing implies
the exclusion of another thing — is therefore applicable in the instant case since murder and
assault, not having been expressly included in the enumeration of the circumstances that
would negate liability in said insurance policy cannot be considered by implication to
discharge the petitioner insurance company from liability for, any injury, disability or loss
suffered by the insured. Thus, the failure of the petitioner insurance company to include death
resulting from murder or assault among the prohibited risks leads inevitably to the conclusion
that it did not intend to limit or exempt itself from liability for such death.
intentional injuries inflicted by the insured or any other person, etc., implies the exercise of
the reasoning faculties, consciousness and volition. Where a provision of the policy excludes
intentional injury, it is the intention of the person inflicting the injury that is controlling. If the
injuries suffered by the insured clearly resulted from the intentional act of a third person the
insurer is relieved from liability as stipulated.
In the case of Hutchcraft'sEx'r v. Travelers' Ins. Co., 87 Ky. 300, 8 S.W. 570, 12 Am. St. Rep.
484, the insured was waylaid and assassinated for the purpose of robbery. Two (2) defenses
were interposed to the action to recover indemnity, namely: (1) that the insured having been
killed by intentional means, his death was not accidental, and (2) that the proviso in the policy
expressly exempted the insurer from liability in case the insured died from injuries
intentionally inflicted by another person. In rendering judgment for the insurance company the
Court held that while the assassination of the insured was as to him an unforeseen event and
therefore accidental, "the clause of the proviso that excludes the (insurer's) liability, in case
death or injury is intentionally inflicted by another person, applies to this case."
In Butero v. Travelers' Acc. Ins. Co., 96 Wis. 536, 65 Am. St. Rep. 61, 71 S.W. 811, the
insured was shot three times by a person unknown late on a dark and stormy night, while
working in the coal shed of a railroad company. The policy did not cover death resulting from
"intentional injuries inflicted by the insured or any other person." The inquiry was as to the
question whether the shooting that caused the insured's death was accidental or intentional;
and the Court found that under the facts, showing that the murderer knew his victim and that
he fired with intent to kill, there could be no recovery under the policy which excepted death
from intentional injuries inflicted by any person.

Biagtan v. Insular Life Assurance Company, Ltd.

G. R. No. L-25579, 29 March 1972
44 SCRA 58

Facts:
Juan Biagtan was insured with Insular Life in which the policy include an "accidental death
benefit clause,"providing that if "the death of the insured resulted directly from bodily injury
effected solely through external and violent means sustained in an accident... and
independently of all other causes," but will not apply where death resulted from an injury
"intentionally inflicted by another party." Later on, a band of robbers entered the house of
Biagtan who was eventually killed in the process. The family of the insured filed a claim with
Insular Life but only paid the covered proceeds, which did not include the "accidental death
benefit clause" sum on the ground that the injuries were "intentionally inflicted," thus, the
action in court, which ruled in favor of Biagtan.

Issue:
Whether or not the injury resulted in the death of Biagtan was considered intentional.

Held:
Yes.
Court decisions in the American jurisdiction, where similar provisions in accidental death
benefit clauses in insurance policies have been construed, may shed light on the issue before
Us. Thus, it has been held that "intentional" as used in an accident policy excepting